Multidrug-resistant tuberculosis: Treatment and outcomes of 93 patients.

Sarah K Brode,Jane Mcnamee,Robert Varadi,Frances B Jamieson,Nina Malek,Sharon Stewart,Monica Avendano

doi:10.1155/2015/359301

Sarah K Brode, Jane Mcnamee + Show 5 more

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https://doi.org/10.1155/2015/359301

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Abstract

Tuberculosis (TB) remains a leading cause of death worldwide and the emergence of multidrug-resistant TB (MDR TB) poses a threat to its control. There is scanty evidence regarding optimal management of MDR TB. The majority of Canadian cases of MDR TB are diagnosed in Ontario; most are managed by the Tuberculosis Service at West Park Healthcare Centre in Toronto. The authors reviewed 93 cases of MDR TB admitted from January 1, 2000 to December 31, 2011. Eighty-nine patients were foreign born. Fifty-six percent had a previous diagnosis of TB and most (70%) had only pulmonary involvement. Symptoms included productive cough, weight loss, fever and malaise. The average length of inpatient stay was 126 days. All patients had a peripherally inserted central catheter for the intensive treatment phase because medications were given intravenously. Treatment lasted for 24 months after bacteriologic conversion, and included a mean (± SD) of 5 ± 1 drugs. A successful outcome at the end of treatment was observed in 84% of patients. Bacteriological conversion was achieved in 98% of patients with initial positive sputum cultures; conversion occurred by four months in 91%. MDR TB can be controlled with the available anti-TB drugs.

Highlights

Tuberculosis (TB) remains a leading cause of death worldwide and the emergence of multidrug-resistant TB (MDR TB) poses a threat to its control
In the present retrospective review of 93 MDR TB patients treated at West Park Healthcare Centre, we found that 84% of patients achieved a successful outcome at the end of treatment
Sputum culture conversion occurred quickly in most patients with pulmonary MDR TB; conversion occurred by two months of therapy in 66% of patients and by four months in 91%

Summary

Introduction

Tuberculosis (TB) remains a leading cause of death worldwide and the emergence of multidrug-resistant TB (MDR TB) poses a threat to its control. There is scanty evidence regarding optimal management of MDR TB. The majority of Canadian cases of MDR TB are diagnosed in Ontario; most are managed by the Tuberculosis Service at West Park Healthcare Centre in Toronto. All patients had a peripherally inserted central catheter for the intensive treatment phase because medications were given intravenously. Treatment lasted for 24 months after bacteriologic conversion, and included a mean (± SD) of 5±1 drugs. A successful outcome at the end of treatment was observed in 84% of patients. Bacteriological conversion was achieved in 98% of patients with initial positive sputum cultures; conversion occurred by four months in 91%. Conclusions: MDR TB can be controlled with the available antiTB drugs

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